Maternal Requests and Child Compliance during Mother-Child Interactions in Adolescents with Fragile X Syndrome or Autism

Abstract

Requests for action are used to ensure an action is completed. Parents use requests for action expecting that their child will comply with their requests. However, children are not always compliant. Noncompliance may be due to difficulty comprehending the request, especially when the request is complex or does not meet social expectations. Requests can vary in three different properties: directness, transparency, and conventionality. For instance, parents may use indirect requests (e.g., “Do you mind putting away the dishes?”), ambiguous requests (e.g., “Next we open the bag.”), or unconventional requests (e.g., “It would be great if the dishes were put away.”). Individuals who have cognitive, linguistic, and social delays or impairments, such as those with fragile X syndrome (FXS) or autism spectrum disorder (ASD), may have difficulty interpreting such requests. The general purpose of this study was to examine the extent to which language, nonverbal cognition, social skills, autism symptoms, and request properties predicted compliance with maternal requests for action by adolescent males with FXS or ASD. Thirty-six adolescent males with FXS and their biological mothers participated in an ongoing longitudinal study, and an additional two participants with ASD and their mothers were recruited. Adolescents ranged from 12 to 18 years old. With their mothers, the adolescents completed a 10-minute snack task which was videotaped. Each video was coded behavior-by-behavior and from this, maternal requests for action and child compliance were assessed. Additionally, adolescents completed assessments of language and their mothers completed a parent-report interview of their son’s adaptive behavior. Autism symptomology and nonverbal cognition were also assessed in the FXS group. The effects of request property, language, nonverbal cognition, social skills, and autism symptomology were considered using a series of multilevel regressions. Results indicated that language ability and nonverbal cognition were strongly associated with compliance, as were social skills. Request properties were not associated with compliance. Autism symptomology was also associated with compliance such that individuals with higher autism symptom severity were less likely to comply. The two participants with ASD performed similarly to the FXS group on all measures. Adolescent males with FXS or ASD were largely compliant with maternal requests for action regardless of request directness, transparency, or conventionality. Although the participants demonstrated high levels of compliance, individual differences in language, nonverbal cognition, and social skills accounted for some variation in compliance. Findings suggest that adolescent males with FXS who have lower language or social skills or who have elevated autism symptomology are less compliant. Additional adolescent characteristics and/or contextual demands may further predict compliance, so future research will need to identify and examine other potential predictors. This research highlights the ways in which parent language use may impact child behavior and demonstrates that there is no gold standard way for mothers to present requests that will promote compliance in adolescent males with FXS or ASD.